Health

“Patients Waiting To See A Doctor, With Figures Representing Their Fears” by Rosemary Carson (via wikimedia)

Most people have some form of a lurid narrative about drugs, exploitation, childhood abuse, and mental illness come to mind when they imagine the life of a sex worker. However, sex workers’ relationships to their identity are far more complex and difficult to characterize than that trite narrative allows for. When it comes to sex workers who do live with the stereotypical trope of also having a mental illness, it becomes even more essential to uncover what these sex workers themselves have to say about their lived experiences of that mental illness and sex work.

People diagnosed with mental illness frequently have their decisions invalidated and undermined by the dominant culture. Many individuals who do not have much experience with mental illness will attribute any socially unacceptable behaviors to “mental illness.” In much the same way, people who have never been in the sex industry tend to sideline the decisions of sex workers by inferring that trauma or abuse must have predestined them to a life in the sex industry. When people who are neither mentally ill nor in the sex industry say these things, they are robbing us of our ability to exert agency.

Amber, a full-service worker from Washington DC, states, “I very strongly believe that the way that society treats sex workers, mentally ill people and other marginalized communities (that often intersect)…[is] based on kyriarchal/patriarchal, colonialist, and capitalist systems of control. In order to treat marginalized people better, I think we all have a lot of work to do regarding the unlearning of certain stigmas and stereotypes.”

The presence of stigma is one the key aspects of institutional violence keeping communities and individuals subjugated. It proliferates because it benefits those in power in this way. Stigma creates legal and moral justifications for the criminalization of sex work in America. It also creates an environment in which mentally ill people can be stripped of their rights through court-ordered institutionalization, coerced medication, and the assignation of relatives as proxies to control them legally and financially. The disqualification of the decision-making abilities of communities on the margins is a weapon of the oppressor.

Tara Johnson, a stripper from Portland, Oregon, elaborates on the ways in which decision making can be invalidated based on association with the sex industry, especially if one also has a diagnosis of mental illness: “Just because I’m (sometimes) crazy, doesn’t mean I’m wrong. My sex work was not me acting out, or indulging in yet another form of self-harm. It was nothing that entitles people to belittle my full humanity. It’s nothing that automatically means that mentally ill sex workers, especially ones who may have other issues too (drug use, etc.) should automatically be deprived of the rights that privileged, able-bodied civilians are entitled to.”

Sex work is not a dysfunctional behavior stemming from our disease. Rather, it is often the best choice we can make to adapt to our mental illness. In truth, many people with mental illness find sex work helpful in a variety of ways as an occupational choice. It gives us a less rigorous schedule which allows for more emotional instability. Sex work can also affirm us as something we can excel at when mental illness has hindered our success in more traditional pursuits.

Dear Ms. Harm Reduction, I’ve been escorting and doing pro domme work for a year and a half. Sometimes I do a gram of coke with regulars, or even do drugs with new clients on occasion. I’d like to be smart about this, but I feel like I can’t ask the the sex workers I know for advice because none of them would ever take that risk in the first place. Do you have any tips on how to stay safe while partying with clients? Wilder Than (my) Friends

Gabrielle is the Care Coordinator for Persist Health Project. Persist Health Project is a peer-led, community-based health and community organizing project for sex workers based in Brooklyn, New York. As Persist’s Care Coordinator, Gabrielle vets service providers, provides community members with supportive referrals, and helps lead Persist’s Best Practices Trainings.

While many of us dream of the ideal client who will deposit money annually into our retirement fund or enroll us in their kick-ass work health insurance plan, he probably won’t come along for all of us. Here are some things you can do to get quality health care service in the meantime without breaking the bank:

1. First things first, you could be eligible for government subsidized health insurance through Medicaid! Check with an Affordable Care Act (ACA/Obamacare) navigator to see if you are. You can also call a Medicaid Hotline (1-800-541-2831) to check your eligibility. If you make under $1,300 a month (for a single person, that number goes up with family size) in reported income, are pregnant, or have recently had a child, you may be eligible for Medicaid. If you have recently been diagnosed with HIV you are also eligible for AmidaCare through Medicaid.

While open enrollment for the ACA has ended, if you are eligible for Medicaid or government assistance with your health care plan you are still able to enroll without a fee. Reach out to Callen-Lorde Community Health Center if you think you might be eligible and get enrolled today!

Ms. HR wants the best for you and your bun in the oven. Though you probably won’t want to nurse your tot if you’re on methadone after it’s born. (“Nurse the Baby” poster by Erik Hans Krause, via Wikipedia Commons)

All the queries Ms. Harm Reduction answers are actual questions from readers. If you have a quandary related to drugs, sex, work, or any of the other pitfalls and pleasures of life that you need Ms. Harm Reduction’s solution for, please write in at info@titsandsass.com.

Dear Ms. Harm Reduction, I’m a recovering addict/alcoholic stripper (20 months clean) and I just found out my best friend at work is a pregnant heroin addict. I’m one of the only people who knows she is pregnant, and I’ve been trying to talk her into getting some prenatal care as well as food stamps and WIC because she never seems to have enough to eat. Last week I learned that she doesn’t want to go to the doctor about her pregnancy because she’s a heroin addict. The resident dope dealer/stripper [at work] (also a pretty close friend) confided in me that she is also worried about her. I always thought she was falling asleep at work because she works too much but now I realize she was nodding off, and now I also understand why she never has enough money despite doing well at dancing and why she’s so underweight. Lately, she’s been looking extra pale, dark circles under her eyes, and crying a lot. I’m worried. I know she’s hiding her addiction from me because she knows I’m in recovery and because I’m somewhat of a mentor to her and she doesn’t want to disappoint me. I also understand firsthand the painful shame that often accompanies drug addiction.

I don’t want to embarrass her or make her feel defensive, but I also want to let her know that I do love her regardless and most importantly I would like to give her some information about harm reduction. Is there a way I can go about this that won’t feel invasive? I know a former sex worker who works at a harm reduction center that will give her clean needles. I’ve also been hearing a lot about a bad batch of heroin that’s been going around my city. We’ve had a huge spike in overdoses and I want to make sure she knows it’s out there.

And finally, what the hell is a pregnant drug addict supposed to do? Will she be arrested when her baby tests positive for heroin? Drug addict or not, she needs prenatal care. I can understand the difficult position she is in.

I’m not naive enough to think I can talk her out of her addiction, but I also don’t want her to feel like she needs to hide it from me. I want her to know I’m not judging her and that I’m here to help her if she decides she needs it.

Amanda Brooks is the acclaimed author ofThe Internet Escort’s Handbookseries, the first one of which she published in 2006. They served as an important resource for escorts advertising online back when there were few other how-to sources on the topic. She was also one of the earliest escort bloggers starting in 2005, writing entries brimming with eloquence and common sense atAfter Hours.

The two fell off the map recently.

When they returned, we were shocked to read Brooks’ blog post about what they’d endured: a campaign of terror by one of Brooks’ clients, affluent lawyer Percy LaWayne Isgitt. Isgitt—Brenneman and Brooks call him “Pig”—caused both Brenneman and Brooks severe brain injuries when his arrogance and negligence piloting a plane the three of them were in led to a catastrophic “hard landing.” Despite the fact that Brooks was clearly incapacitated and near death, Brenneman had to browbeat Pig into taking her to the hospital the next day. Once Brooks was checked in, Pig fraudulently signed in as her relative and attempted to control her treatment. Despite her still severely injured state, Brooks continued to see Pig as a client for two sessions after her hospitalization, in desperate need of money to pay for medical bills. When she finally tried to break ties with him, he hired people to make threatening phone calls to both women. In response, Brooks went into hiding, so Pig sent men to stalk, rape, and beat Brenneman on a number of occasions, trying to discover Brooks’ location. Neither the police, nor the many medical facilities that misdiagnosed them along the way, nor the personal injury lawyer they hired were any help to the two women against a deranged, abusive man with wealth and social capital.

The injuries Brenneman suffered from the plane crash combined with the injuries she sustained from the attacks led to the fatal exacerbation of her previous medical conditions. Her doctors have told her she has very little time left to live.

This story illustrates the insidious way institutions empower abusers to commit violence against sex workers. The only people they can often rely on in these situations are other sex workers. You can read the original account here and donate to their Giftrocket account using this email address: abrooks2014@hush.com. Donations will be shared equally between them to cover their respective medical costs.

Amanda, you write in your blog post, in reference to Jill’s past abuse:

To those who doubt, her stories are true. They’re things only men would think up and most of the time, it’s the mundane details that stand out the most to both of us. I’ve read stories from so-called trafficking victims who describe ridiculous “Satanic” rituals or elaborate set-ups. The truth is, the men who were Bruce’s [Jill’s captor’s] clients weren’t very bright, in my opinion, and they had a lot of the same stupid fantasies and beliefs that most vanilla clients do—only much darker and violent.

This factor plays into your story of how Pig hurt you both, too. There’s a voyeuristic undertone to the way people listen to stories of abuse. People expect the “elaborate set-ups,” and yet abuse is usually no different than other misbehavior in kind, if not in degree—abusers do it because they want to feel big, or because they care about themselves a lot more than they care about anyone else. How do you think the fact that often stories of abuse are mundane and banal makes it harder for victims to get help?

Jill Brenneman: People don’t want to believe the mundane stories, they want to believe the exotic stories. Like a wife who gets hit. Unless she’s put in the hospital, no one cares. Or she returns home because she has children. But the trafficking victim imported from Estonia gets all the attention.

Amanda Brooks: Because they’re too believable or not dramatic enough. [Pig] raped me twice, yet it’s not something most people acknowledge as rape. It even took me a while to realize that it was rape, despite how I felt about it. People like to parse situations down to the point where the only way it’s “real” is if it’s outlandish.

Jill, you were held captive by a sadist for three years in your teens, and forced to endure unimaginable abuse. As an adult you returned to sex work voluntarily to make a living, and then you went through this ordeal with Amanda at Pig’s hands. What unusual problems have you faced as a sex working abuse survivor? What can we do as a movement to make things better for the abuse survivors among us?

Jill: The ordeal that Amanda went through made me livid and still does.

Working as an abuse survivor led me to more abuse. I learned from [my captor and abuser] Bruce in the 80’s. Bruce was a cliche master sadist. There was never a sense of love or affection between him and I. I was an object. I did what I was was told. I was taught how to relate to clients. I overapplied this training as an adult. I willingly went back to work as a professional submissive. This was a place that I did not belong. Despite there being a 19 year gap between [my captivity and going back to] sex work, I did not belong in sex work —especially as a professional submissive. I needed the money to pay for very expensive subcutaneous blood thinners because of a clotting disorder. I needed to pay the rent, the car payment, food, care for the dog, etc. I took the work that came. I started off with two old pictures of myself, no website, no reviews, and took some pro-sub clients to make money when it was tight. I did not belong in sex work. I was still far too impacted from previous abuse to be doing it but I had no choice, I needed the money.

The most important thing the movement needs to do is work on decriminalization so that we have options.

Amanda: The movement truly doesn’t have the power to deal with this, unfortunately. Until the laws are changed, we never will.